Ivanka Trump doesn’t understand how reproductive health care works

This is not the advocate you’re looking for.

Ivanka Trump, daughter and adviser of U.S. President Donald Trump arrives for the W20 summit in Berlin, Tuesday, April 25, 2017. CREDIT: Michael Kappeler/dpa via AP

Ivanka Trump wants the world to know that she’s a feminist. Under the hashtag #womenwhowork (also the title of her new book on women in business, which was released on Tuesday), she’s spent the past few years building a brand based on how to be a woman who “has it all” — the adorable children, the high-powered job, and the tasteful Ivanka Trump™️ sheath dress, too, of course.

Now, as the first daughter and as an official White House aide, Ivanka has said she plans to be a “moderating” force on her brash father, and wants to turn her focus on women’s empowerment from selling pumps to crafting policy.

The problem? Ivanka’s advocacy is often all style and no substance, and she has repeatedly revealed fundamental misunderstandings about the actual barriers facing many women and gender non-conforming people who don’t benefit from the privileges afforded to men.

And on Tuesday, a line in a New York Times profile on Tuesday highlighted yet another area of ignorance: reproductive rights.

Here is the relevant section, from near the end of the article (emphasis mine).

“with congressional Republicans threatening to cut all funding to Planned Parenthood (even though the women’s health organization says it receives no federal funding for abortions), Ms. Trump approached its president, Cecile Richards, to start a broader dialogue. She also had a proposal: Planned Parenthood should split in two, Ms. Trump suggested, with a smaller arm to provide abortions and a larger one devoted to women’s health services.”

Firstly, Planned Parenthood doesn’t just say it doesn’t receive federal funding for abortions — it doesn’t, full stop. That’s because it’s currently illegal under the Hyde Amendment, which prohibits taxpayer funds from paying for abortion.

In reality, most of Planned Parenthood’s federal funding comes from Medicaid payments for basic health care services. That means that congressional Republicans’ current crusade to defund Planned Parenthood is actually a push to prevent low-income people on Medicaid from going to the organization’s clinics for care such as cancer screenings, birth control consultations, prenatal care, and STD tests. Stripping federal funding from the group will mean preventing many low-income people from being able to access this care at all.

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But Ivanka’s solution — to segregate Planned Parenthood’s abortion care from its other health care services — also betrays a deep misunderstanding of the interconnected nature of reproductive health.

Abortion care is health care. It cannot be neatly separated from other medical decisions; for many people, having control over when and if to have a child is fundamental to their health and economic well being. And though abortion care may represent a small percentage of Planned Parenthood’s overall services, it is central to the group’s mission of providing reproductive care.

To Ivanka and other abortion opponents in government, Planned Parenthood’s insistence on providing abortions may seem like an ideological stand — or as Ivanka put it, an adherence to “thesis” over reality.

Ivanka, the Times reports, complained that advocacy groups were “so wedded to the headline of the issue that sometimes differing perspectives and new information, when brought to the table, are viewed as an inconvenience because it undermines the thesis.”

This belief isn’t confined to the right. Sen. Bernie Sanders (I-VT) set off a firestorm in late April by campaigning for an Nebraska mayoral candidate who once supported abortion restrictions. Sanders, in response, argued that “you can’t just exclude people who disagree with us on one issue,” and emphasized that his primary focus was on economic policy, rather than reproductive or cultural issues.

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But the truth is, for many people, an unwanted pregnancy is an economic issue. Obviously, it represents an unexpected medical cost. And whether or not a patient has the means to cover that cost has a lot economic consequences; low-income people who cannot get the abortion they wanted often end up slipping deeper into poverty. Framing abortion as just a social or cultural issue is deeply misleading, and buys into an anti-abortion framework that ignores the needs of real women and others who can get pregnant.

Which is why, when the White House floated a similar proposal to Planned Parenthood in March — suggesting the group could keep its federal funding if it stopped providing abortion care altogether — it was roundly rejected, as was Ivanka’s plan to split the organization in two.

“Asking Planned Parenthood to abandon our patients in need of safe abortion care in order to preserve our ability to provide cancer screenings and birth control is not a ‘common-sense’ idea. It is exactly what anti-women’s health activists have been pushing for years as part of their goal to outlaw abortion entirely,” Dawn Laguens, Executive Vice President of Planned Parenthood said about Ivanka’s proposal. “Providing critical health care services for millions of American women is nonnegotiable.”

This approach, however, of separating abortion care off from other services has gained traction among Republicans who worry about balancing their extreme pro-life agenda with the political fallout of dealing a disastrous blow to low-income people’s ability to receive health care. And if the GOP health care plan passes, the artificial separation may become policy.

The GOP plan prohibits tax credits from going toward purchasing health insurance plans that cover abortion care — treating abortion as a separate issue rather than an unexpected medical cost like any other.

Technically speaking, the provision does not prevent insurance plans from covering abortion care — people could pay extra for the coverage as an add-on. In reality, though, it means that patients and small businesses that rely on these tax credits to offset costs will have to pay more for abortion coverage. It would make providing abortion coverage more expensive and logistically complicated, and correspondingly, could set off a spiraling effect as the number of purchasers got lower, driving the cost higher.

This would have a sweeping effect through the entire insurance industry, making it difficult even for women with private insurance to receive affordable abortion care.

“The status quo is that abortion has been regularly covered — not called out, not controversial — as part of general medical coverage in private health insurance,” Susan Woods, an associate professor of health policy at George Washington University, told ThinkProgress about a similar bill proposed in the House two years ago. In effect, she said, such policies “could really change the nature of the insurance market such that ultimately it becomes the norm not to cover abortion.”

Meanwhile, the GOP’s current health care plan still prohibits Planned Parenthood from receiving any federal funding.

Planned Parenthood’s insistence on providing affordable and accessible choices across the spectrum of reproductive health is a matter of substance, not style — unlike Ivanka’s own advocacy, which is often exactly the opposite.